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Kitsap Physical Therapy and Sports Clinics - Silverdale
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Review shows exercise therapy one of the best shoulder treatments: Comprehensive study needed to pull together all research on the topic Complaints related to shoulder pain are the third-most common after those of the back and neck. About 29 out of every 1,000 individuals will have an issue with shoulder pain each year, and it has the highest incidence in women and people between the ages of 45-64. About 36% of these individuals have a condition called shoulder impingement syndrome (SIS), which is a generic term for several shoulder disorders that all lead to pain, disability and a reduced quality of life. There are many conservative (non-surgical) treatments available for SIS and an abundance of research on their effectiveness, but there is yet to be a comprehensive overview that has pulled all of these studies together and compared them to one another. For this reason, a powerful pair of studies called a systematic review and meta-analysis was conducted to provide this needed overview on various conservative treatments for SIS. Six databases searched for relevant studies Investigators performed a search of six major medical databases for high-quality studies called randomized-controlled trials (RCTs) that evaluated the effectiveness of a conservative treatment for SIS. RCTs randomly assign participants to a treatment group and then compare them to one—or more—other groups to gauge how well an intervention works, and they are considered the gold standard of individual research studies. This search led to 324 RCTs being screened and 200 of these being accepted into the final analysis. Conservative treatments evaluated in these studies included exercise therapy, a form of hands-on therapy called manual therapy, steroid injections, taping and non-steroidal anti-inflammatory drugs (NSAIDs), among others. Once collected, the findings from these RCTs were compared to one another and the quality of each study was assessed to determine how reliable these findings actually were. Despite low quality of evidence, exercise is still recommended for patients with SIS On the whole, results were supportive of both exercise therapy and manual therapy for SIS patients. For pain alone, studies showed that manual therapy was superior to no treatment or a sham treatment, and that when combined with exercise, it was more effective than exercise alone. Manual therapy was also found to have immediate effects. Regarding pain and function, exercise therapy was found to be superior to no treatment, and specific exercises were found to be more effective than non-specific exercises. Finally, studies also showed that exercise therapy was superior to non-exercise modalities—like ultrasound and electrical stimulation—for improving flexibility. Unfortunately, the quality of the research was deemed very low, which was due to lack of consistency across studies and a high risk of bias. But in spite of this shortcoming, the researchers still concluded that exercise therapy should be recommended as the first line of treatment for SIS patients, and that adding manual therapy may lead to even better results. Individuals dealing with SIS symptoms are therefore encouraged to see a physical therapist for a comprehensive treatment program that is sure to include various exercises and manual therapy. Patients should also be aware that visiting a physical therapy clinic now can be especially advantageous if they already met their insurance deductible or out-of-pocket maximum for 2018, since these visits may be covered for the rest of the year. -As reported in the September ’17 issue of the British Journal of Sports Medicine http://dlvr.it/Qr6hst
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Honoring all who have served our country. http://dlvr.it/QqynS1
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Learn about overuse injuries that occur in rowing. #SeeAPT1st: Learn about overuse injuries that occur in rowing. #SeeAPT1st Click Here for the Article http://dlvr.it/Qqqf39
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Exercise found to reduce risk of experiencing episodes of neck pain: All reviews on the topic up to this point suffered from certain flaws Neck pain is one of the most common and significant health problems throughout the world. It ranks as the fourth leading cause of disability, and it’s estimated that about 48.5% of the population will deal with neck pain at some point in their lives. Individuals with neck pain generally improve over time, but in many cases the pain comes back and can end up becoming a long-term problem. This shows why it’s important to establish measures that will prevent neck pain from developing in the first place, but the available guidelines for neck pain treatment don’t include any specific recommendations for prevention. In addition, although there are large-scale reviews—systematic reviews—on the topic, they all suffer from some flaws and limitations, which means that better quality evidence is needed. For these reasons, researchers decided to conduct a powerful pair of studies called a systematic review and meta-analysis to determine what strategies were most effective for preventing an initial episode of neck pain in individuals without symptoms. Five databases searched for relevant studies Investigators used five medical databases to search for randomized-controlled trials (RCTs) that evaluated the effectiveness of prevention strategies for neck pain, and only accepted those that fit specific criteria. RCTs randomly assign participants to a treatment group and then compare them to one—or more—other groups to gauge how well an intervention works, and they are considered the gold standard of individual research studies. This search led to 5 RCTs being accepted into the systematic review and meta-analysis, which contained data on 3,852 participants. Once collected, the findings of these five RCTs were compared to one another, and their quality was assessed to better indicate if these findings were reliable. Exercise identified as an effective strategy for preventing neck pain Two of the five RCTs investigated the use of exercise programs, and researchers deemed that there was moderate-quality evidence that exercise does substantially reduce the risk of a new episode of neck pain. These exercise programs lasted for 9-12 months and consisted of various exercises that were intended to improve the strength and flexibility of the neck muscles and improve body awareness, stability and aerobic abilities. The individuals who participated in these programs reduced their risk for developing neck pain by about half. The three other RCTs investigated the use of ergonomic programs, which instruct patients make modifications to their workstations and homes that are intended to improve posture. Researchers concluded that there was low-quality evidence that these ergonomic programs do not reduce the risk of a new episode of neck pain. Based on these findings, it appears that exercise is a particularly effective strategy for reducing the risk of developing neck pain. Individuals who work a desk job and are concerned that neck pain may be a problem in the future are therefore encouraged to see a physical therapist for a preventative exercise program, which can put them ahead of the game. Now is also a great time of year to visit a physical therapist for those who have already met their insurance deductible or out-of-pocket maximum for 2018, as treatment may be covered for the rest of the year under some healthcare plans. -As reported in the July ’18 issue of the Journal of Physiotherapy http://dlvr.it/QqYbr7
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Motivational Monday: -Zig Ziglar http://dlvr.it/QqT5fP
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Spine strengthening exercises lead to improvements: Condition generally tends to progress with age Kyphosis is a disorder in which an excessive outward curvature of the spine results in an abnormal rounding of the upper back. Kyphosis generally tends to get worse with age, and once the angle progresses past 40°, it's referred to as hyperkyphosis. Up to 40% of adults over the age of 65 have hyperkyphosis, and those with severe cases are at an increased risk for falls and fractures. Many older adults with hyperkyphosis suffer from poor and worsening quality of life and physical function due to their condition, and it's therefore important to develop strategies to address their disorder. Previous research has shown that strengthening exercises for the back muscles can lead to improvements in patients with hyperkyphosis, but most of the included studies on the topic suffered from limitations of some sort. For this reason, a powerful study called a randomized-controlled trial (RCT) was conducted to evaluate if strengthening exercises were, in fact, effective for patients with hyperkyphosis. In the research world, RCTs are considered the gold standard for determining the benefits of a particular treatment. 99 older adults are randomly assigned to one of two groups Individuals over the age of 60 diagnosed with hyperkyphosis were invited to participate in the study and screened by the team of researchers. In order to be accepted to the RCT, they had to be able to walk one block without an assistive device, climb one flight of stairs and rise from a chair without the use of their arms. From a pool of 598 individuals, 99 were deemed eligible and then randomly assigned to one of two groups. Half the participants were placed in the treatment group, which consisted of three hour-long weekly exercise sessions every week for six months. These sessions were led by a physical therapist and included various exercises that targeted muscle impairments that were known to be associated with hyperkyphosis. In particular, the exercises focused on strengthening and improving the flexibility of certain back muscles, and participants were also given the training to help improve their posture. The other half of participants were placed in the control group, which attended an education session every month for four months. All patients were assessed at the start of the study and then six months later for the curvature of the spine and several other outcomes. Treatment leads to significant improvements Results showed that patients who followed the physical therapist-led exercise program experienced several significant improvements when compared to the control group. Most importantly, the angle of the curvature of the spine reduced by an average of 3.3° in the treatment group, compared to only 0.3° in the control group. In addition, the treatment group reported better self-image and satisfaction with their appearance after completing their treatment. The findings of this RCT suggest that a treatment program that consists of strengthening exercises for the spine and posture training can lead to physical improvements in patients with hyperkyphosis, which appears to boost their confidence in turn. Individuals with hyperkyphosis interested in improving should, therefore, think about seeking out the services of a physical therapist to address their condition. -As reported in the July '17 issue of the Osteoporosis International http://dlvr.it/QqB66n
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Happy Halloween! http://dlvr.it/Qq42yk
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Reducing elbow injury in young pitchers requires effective prevention: Far too many players are being encouraged to 'play through their pain' Participation in youth sports has been increasing at a rapid rate throughout the country, and there are now more young players involved in Little League baseball than ever before. But unfortunately, the growth in popularity of baseball has also led to an epidemic of arm injuries in young throwers: recent statistics suggest that between 30-40% of 7-18 year-old baseball players experience elbow and shoulder pain during each season. To make matters worse, it's been found that about 46% of these injured adolescents are encouraged to stay active and "play through the pain," as it were. This is incredibly dangerous for young, developing athletes, as failing to recognize and treat an injury can lead to a far worse problems later in a career. Of particular interest are overuse injuries, which result from too much time playing one sport-like baseball-without enough rest. Tears of the ulnar collateral ligament (UCL) in the elbow are one of the more common overuse injuries in youth baseball, and the rate for surgery to treat these injuries is increasing significantly. Together, this highlights the need for a better understanding of why the number of elbow injuries in youth baseball is so high and for appropriate, effective strategies to prevent and treat them. With this in mind, two surgeons authored a commentary on the topic and their opinion on how to address the issue. Why specializing in one sport is so risky Perhaps the biggest factor that contributes to the high rate of injuries in youth baseball is specializing in one sport. This essentially means that these young players are involved in baseball exclusively-or nearly exclusively-and do not participate in other sports as well. Studies have shown that young athletes who play a single sport for more than nine months in a year have a 36% increase in risks associated with severe overuse injury compared to those who do not. The reason is that baseball is a demanding sport, and without sufficient time to let the body recover, the repeated trauma can lead to small damage that will grow into a more serious injury over time. Conditioning programs created by physical therapists can help prevent overuse injuries Due to this issue with one-sport specialization, one of the most effective ways to prevent overuse injuries is by educating baseball players about these dangers and encouraging them to not overdo it. This can be accomplished by enforcing pitch counts for young players and regulating the number of leagues and number of months that they participate in baseball throughout the year. In addition, conditioning programs that improve the strength and flexibility of the hips, back and legs can actually reduce strain on the arms and therefore reduce the risk of elbow injuries. Physical therapists are movement experts that can create these types of conditioning programs for any level of play and can modify them according to the demands of the team. Finally, young players should be urged to engage in other sports aside from baseball to increase their fitness levels and protect them from overuse injuries. Injured players must adhere to their rehabilitation programs and take them seriously If an injury of any sort does occur, it's important to carefully discuss the details of it with the player, and to include their parents. Although many players and parents may have difficulty accepting that playing time needs to be stopped for a period of time or that surgery is required, these recommendations need to be taken seriously. Fortunately, most partial UCL tears can be successfully treated without surgery through a course of rehabilitation administered by a physical therapist. These programs typically include a variety of stretching and strengthening exercises, baseball-specific movements and recommendations to take some time off from throwing. In more severe cases, surgery may be needed to repair a completely torn UCL, but physical therapy will still be needed during the recovery afterwards. Regardless of the recommended treatment, it's essential that young patients adhere to the rehabilitation program given to them and do not rush their return to baseball until they are given the OK to do so. Together, following these guidelines will reduce the risk of throwing-related elbow injuries in youth baseball and help to ensure longer, healthier careers for these developing athletes. -As reported in the May '18 issue of JOSPT http://dlvr.it/QpxtTK
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Stay in the game, tips on how to prevent soccer injuries. #SeeAPT1st: Soccer is a great sport for kids and adults, follow these tips to keep your kids in the game now and long into the future. #SeeAPT1st Click Here for the Article http://dlvr.it/QpYJbN
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Two types of strength exercises lead to improvements for tennis elbow: Unclear whether one intervention is superior to the other Lateral epicondylitis, or tennis elbow, is a common condition that results from inflammation of the tendons that join the forearm muscles on the outside of the elbow. Tennis elbow develops from overuse in sports and is frequently seen in athletes that play tennis and other racquet sports, but it can also develop in anyone that repeatedly performs activities that require the elbow and wrist. Although the majority of individuals that develop tennis elbow will improve after some basic treatments and lifestyle changes, about 20% will continue to have symptoms one year later. When tennis elbow does not improve after three months, it's referred to as “chronic,” which is more difficult to treat. There are many treatment options available for chronic tennis elbow, including a variety of exercises guided by physical therapists, such as eccentric and concentric elbow exercises. Eccentric exercises use the elongation phase of muscle activity, which occurs while lowering weights, while concentric exercises use the contraction phase that occurs when lifting weights. It's not clear which of these—or a combination of the two—is better, and research is limited on the topic. For this reason, a powerful study called a randomized controlled trial (RCT) was conducted to determine if eccentric or concentric exercises led to better outcomes in pain and function for patients with chronic tennis elbow. Patients are evaluated regularly over the course of one year Individuals who had symptoms of tennis elbow for at least three months and a verified diagnosis were recruited and asked to participate in the RCT, which led to 120 of them being accepted. These participants were then randomly and evenly assigned to either the eccentric or concentric exercise group. Both groups were instructed to perform an at-home exercise program designed by a physical therapist for the next three months. The “weight” used for the exercises was a plastic water container with a handle that weighed 1 kg (2.2 lbs) for women and 2 kg (4.4 lbs) for men. Both groups were instructed to hold the handle of the container using a clenched fist with their forearm on the armrest or adjacent table. The eccentric exercise group was instructed to lower the weight downwards while flexing their wrist, while the concentric group was instructed to lift the weight while extending the wrist, both for three sets of 15 repetitions. Participants were to perform these exercises once a day for three months, and the load was increased each week by one dL (0.22 lbs). All participants were evaluated at the start of the study and then one, two, three, six and 12 months later for pain, strength, function and several other outcomes. Both interventions are beneficial, but eccentric exercises lead to better results After one year, results showed that patients in both groups improved in their scores for pain and muscle strength, but the eccentric exercise group experienced greater overall improvements. This was based on the fact that the eccentric group reported a faster decrease in pain during muscle contraction and elongation, as well as a faster increase in muscle strength compared to the concentric group. This difference between groups was most noticeable at two months, but the trend continued up to the final follow-up at one year. Regarding the other outcomes of disability, function and quality of life, there were no significant differences between the two groups, which suggests that they both improved to a similar extent. Based on these findings, it appears that both an eccentric and concentric exercise program are beneficial for patients with chronic tennis elbow for up to one year, but an eccentric program provides a slight advantage of faster and greater improvements in pain and strength. Both of these exercises are routinely included in treatment programs provided by physical therapists in order to elicit positive changes. Patients currently dealing with symptoms of tennis elbow are therefore encouraged to seek out treatment at a local physical therapy clinic to help them start the path to recovery and better overall functioning. -As reported in the September '14 issue of Clinical Rehabilitation http://dlvr.it/QpChk5
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